NPIMap

Individual provider Active NPI

Kathleen Lea Summers, MD, PHD

  • Hospitalist Physician
  • Jacksonville, IL
National Provider Identifier
1750433611
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036103814 Issued in IL
Practice address
1600 W Walnut St
Jacksonville, IL 62650-1136
Phone
(217) 245-9541
Fax
(217) 606-3057
NPI assigned
Jan 18, 2007
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036103814 IL
Hospitalist Physician 208M00000X 036103814 IL Primary

Addresses

Primary practice location

1600 W Walnut St
Jacksonville, IL 62650-1136

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other practice location 1

1600 W Walnut St
Jacksonville, IL 62650
Phone (217) 245-9541

Other practice location 2

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721 ext. 65126

Other practice location 3

616 Westwinds Dr
Jacksonville, IL 62650-3612
Phone (480) 238-2324

Other identifiers 3

IdentifierTypeStateIssuer
L86359MedicaidIL
L97187MedicaidIL
L997718MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160210001694 IL Practitioner - Internal MedicinePractitioner - Hospitalist 6709873334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northwestern University Feinberg Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macoupin Physician Services, PCGroup PAC ID 7416345947, 12 clinicians

Practice addresses (Care Compare)

20733 N Broad St
Carlinville, IL 62626-3710
Phone (217) 854-3141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
036103814ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Macoupin Physician Services, PC Hospitalist CurrentSince Nov 5, 2025 Accepting new patients
Carlinville Area Hospital Association CurrentSince Dec 1, 2025 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Carlinville Area Hospital Association CurrentSince Dec 1, 2025 Accepting new patients
Carlinville Area Hospital Association CurrentSince Dec 1, 2025 Accepting new patients
Midwest Emergency Department Specialists LTD Emergency Medicine Past Accepting new patients
Memorial Medical Center Past Accepting new patients

Locations

20733 N Broad St
Carlinville, IL 62626
Phone (217) 854-3141

1025 S 6th St
Springfield, IL 62703

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/carlin-6115abf3
  • Direct secure messaging: kathleensummers@sfc.allscriptsdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1750433611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-245-9541",
            "fax_number": "217-606-3057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 W Walnut St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "IL",
            "postal_code": "62650",
            "country_code": "US",
            "telephone_number": "217-245-9541",
            "fax_number": "217-479-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011462",
            "country_code": "US",
            "telephone_number": "618-549-0721 x65126",
            "fax_number": "618-529-0479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "616 Westwinds Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "IL",
            "postal_code": "626503612",
            "country_code": "US",
            "telephone_number": "480-238-2324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "KATHLEEN",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036103814",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036103814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L86359",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L97187",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L997718",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.